Nevertheless, nowadays it is difficult to obtain approval of leadership programs without some type of ROI calculation. Leaving aside philosophical differences, the good news is that the same methodology used in deciding to fix a car is used to decide to invest in a leadership program. If I think like an economist, it is quite possible to compare both. The human (mind and body) is far more complex than a car and has many more moving parts.

Whereas a mechanic can maintain or fix a car, it takes highly “specialized mechanics”, with many years of education to maintain or fix a human (mind and body). Furthermore, the parts of the human are interrelated and sometimes not even understood. That explains why there are literally hundreds of types of leadership and workplace care programs compared to taking your car to a single dealer to get it repaired. Each program impacts one or more mind and body parts, leaving other parts to survive on their own.

Implementing a leadership program is like looking after a machine

Let´s continue with the analogy. If an important car part malfunctions, the car stops. Its productivity goes to zero. However, with human beings, if an important component breaks down (say with anxiety or back pain), other parts continue to function (the mind functions) but with less productivity. With a car, either it works or does not, whereas someone with anxiety or depression gives the appearance of productivity (after all, they are at their desk), but the mind does not work on all “cylinders”. Not to mention the impact on in the team functioning.

So, if we can admit that humans have productivity (few would doubt that), it become a question of how to measure the impact of physical and psychological conditions on productivity, and how a specific leadership program impacts the reduction of productivity. Also, if one admits that productivity exists, can I push my luck and claim that productivity varies by occupation and industry. So, if I had a data bases of productivity contributions by country, occupation and industry, I can be quite specific about the cost of conditions and how much they can be reduced by this program.

Read more: 2024 Budget Battles and Employee Wellbeing Programs: Showing the ROI to CFOs

What should you do considerer in a leadership program?

Another consideration is that leadership programs (increasing emotional intelligence mindfulness and leadership skills) impact multiple conditions of the entire employee population (common mental illness, stress, anxiety, depression – associated to those burnout/exhaustion, and physical conditions closely related CHD risk, prediabetes, musculoskeletal conditions).

So, one must look at how the program (in this case, leadership) impacts the productivity costs of each of these conditions among the employees.

• Obviously, there are other cost reductions associated with leadership programs (e.g., medical costs, turnover, disability, accident costs, and recruitment and onboarding external hires on leadership positions) but I have just focused on productivity for now.

• Of course, there is also a team productivity increase outcome from driving higher collective intelligence of the group of individuals lead, efficient problem solving, innovation, cost savings. But I have just focused on initial productivity for now. (note: The leadership program positive impact on the team collective intelligence would happen if the group social sensitivity increases, the distribution of conversational turn-taking becomes better, and the proportion of female group members is significant as a result of this program).

If you can calculate reduced costs, it is possible to calculate ROI. Our website wellcastroi.com contains the specific financial calculations. Obviously, there are other non-quantifiable benefits from having healthier employees (minds and bodies), such as happiness and fulfilment, but luckily the ROI´s generated from just increased productivity are more than sufficient to obtain approval of your leadership program. The rest is gravy.

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I admit that the calculation of ROI for prevention programs is not the easiest of calculations. It involves several complicated steps and this point become financial decision makers reluctant to approve HR investment requests. Read more about 3 basics steps:

The first step

In the ROI calculation process is measuring outcomes in reducing physical and behavioral conditions (which the healthcare industry has done quite well in some areas). However, I have seen many cases where utilization is confused with positive outcomes (e.g., did signing up for a digital platform really do anything? Or taking a thousand steps really reduce CHD?).

The second step

The second and far more difficult step is converting those outcomes into expense reductions. I have seen several very scarry attempts at doing so. Let´s take a simple example, reduction of absenteeism: if a prevention program reduces the number of employees absent, is the savings really salary savings or productivity savings? (Answer: productivity). I know salary savings are quite simple to calculate, but will the financial decision maker be sold on this? The savings in salary must be converted into savings in productivity, which is not quite as simple, unless one is familiar with economic theory and the calculations and data required to do so.

Now let’s take a look at a separate issue for financial decision makers. ROI calculation consistency. Why does every calculation have to be home grown, and not follow the standard formula and include all the standard variables? Examples:

• A case of CHD which will be averted in three years due to a prevention program, has to consider the cost savings in today´s money in ROI calculations.
• The breakeven of an investment in a prevention care program is not “zero”, as the financial director could have invested the money in something secure, like Treasury Bills or something else.
• Several programs impact several conditions simultaneously. An exercise program has an impact on CHD, Diabetes, Stress, and Osteomuscular injuries. Were the savings from all three considered?
• Several programs take years to work. High risk individuals do not miraculously avert CHD in one year. Sometimes it takes two or three years to convert a person with very high risk to high risk. Was a multiple year investment in the program considered?

The third step

Impacting the reluctance of financial decision makers to approve preventive care investment calculations, is that there is always a suspicion that a vendor would never present a negative result. The results look self-serving.

Bottom line: ROI calculations should follow the standard formula, include all the variables in the standard calculation, and be unbiased and independent. Please see our web site if you are interested in finding out more about WELLCAST ROI©. We have been calculating ROI of prevention programs for over 30 years, globally. We are an independent and unbiased provider of ROI calculations for preventive care programs. Let us take this burden off your hands.

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Health promotion, vital for individual and community well-being, receives immense investments from the Federal Government, semi-governmental entities, employers, and health plans. Now here’s the mathematical twist: is this investment paying off as generously as ancient wisdom suggests? It’s a tough call in this fragmented landscape, where defining what falls under preventive care is as clear as mud. Is the focus on addiction, avoiding accidents, or non-communicable diseases like heart disease, diabetes, and mental health the correct focus? Who’s getting the attention, the young, the old, or the working population? Time to ask for a bit of light on this treasure hunt.

Companies should have an important role in preventive care. But how to do it?

Around 20% of the Brazilian population are employed by firms, and employers are expected to provide preventive care programs. It makes sense: the workplace is where you can influence most people. Employers are therefore tasked with implementing ‘Human Sustainability’. And the budget? Well, the employers’ foot the bill. In return, they supposedly should reap the benefits of reduced absenteeism, presenteeism, turnover, and a laundry list of hiring costs. A golden opportunity, right? Yet, no one seems to find the gold on the treasure map.

Employers face the Herculean task of allocating budgets for employee preventive care and deciding: mental health or physical well-being, which programs, which providers, who should implement such programs? It’s a big puzzle, especially when HR already juggles a to-do list the size of an encyclopaedia, and the market’s full of well-being solutions selling eye-popping ROIs. Finance departments tremble at the prospect of asking and receiving no clear answers on which program best suits their staff and how to justify it with numbers.

Read more: What are the ‘Essential ingredients’ of a Wellness Program ROI Calculation?

Hence, the appeal of dismissing preventive programs in favour of technology investments, which have well defined ROI metrics. The result? Preventive care budgets remain modest or get pushed to the next fiscal year. Sometimes, the cheapest program gets implemented just to tick a box. And the gold remains untapped.

ROI calculations following the same methodology as investments in capital equipment is the solution. The calculation methodology must as valid and convincing as those of ROI calculations f other corporate investments.

Calculating the ROI in preventive care

For three decades, Wellcast has witnessed the dazzling ROIs of preventive care programs across countries, industries, and organizations. With the WELLCAST ROI© Calculator, organizations can slap a price tag on their ‘better health and happier minds’ programs. A single calculation and a comprehensive ROI report can light the way for your organization’s mission to care for its employees. You can get your free demo today. Talk to us: https://wellcastroi.com/en/contact/

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Find out about the 3 top challenges for CFOs

1. Budgeting Mysteries: imagine CFOs as modern-day Sherlock Holmes, facing with the difficult riddle of the financial effectiveness of wellbeing programs. It’s like piecing together a puzzle without the luxury of all the puzzle pieces (no epidemiological database on its population, no effectiveness rates of programs, unsure about utilization rates etc).

2. Elusive ROI Clues: just as curious cats chase their shadows; every year CFOs embark on a quest for clear and compelling Return on Investment evidence. It’s as if they’re in pursuit of a financial unicorn through the labyrinth of the most contradictory data of provider claims, each quoting a scientific study.
   
3. Balancing Act: harmonizing the wellbeing spectacle with the bottom-line safety net can finally end up in a marginal investment decision for preventive care programs. Invest most where you can calculate the return.

How to show ROI to CFOs

Showing the ROI of wellbeing programs to CFOs is not as complex as it sounds. The Wellcast ROI Calculator© found its place at the crossroads of employee health and healthy financial investments.

We have launched versions of our ROI Calculators in Brazil, USA, Canada, Mexico, Australia, South Africa, India, and are pleased to announce our newest version, Wellcast Europe, which combines within a single calculator the key country-specific metrics per industry: encompassing productivity and epidemiological databases, the different types of productivity losses per condition based on peer reviewed published studies, effectiveness rates and more.

This combination ends in a user-friendly tool tailored for evaluating the ROI of well-being, wellness, and occupational health initiatives. Covering 31 European countries, including the UK and Turkey, the results obtained are unbiased, scientific, and customized to each specific organization and their specific programs.

Read more: https://wellcastroi.com/en/calculators/

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Separating the Wheat from the Chaff

During the past 30 years we have seen ROI calculators come and go. Most are well intended but are simple calculators that lack the sophisticated calculations and data to meet the more stringent requirements of financial decision-makers. Also, there is a complete lack of consistency in program ROI calculations, whether they be focused on physical, behavioral, or occupational health issues.

So, what are the essential requirements of a valid ROI calculator?

What are the 9 “essential ingredients” of an ROI calculation?

1. Consistency with modern financial theory. They should be the same formulas used to calculate corporate investments in machinery and equipment, opening a new factory, or introducing a new product line. This means that they must include the opportunity cost of money and discounted cash flows.
2. Must Include a valuation of productivity contributions of employeesworking for any employer, in any industry, in any state/region, in any country (these data are needed to calculate improvements in presenteeism and absenteeism). Note that salary is not the same as productivity and should be the first sign that the ROI calculation is meaningless. The productivity contributions of all employees of the country must add up to the GNP of the country and these databases of productivity contributions must also be consistent among countries. Furthermore, there must be a way of adjusting the productivity contributions to differentiate between the more profitable employers versus a less profitable employer in the same industry. Finally, the productivity database must be updated, as economic conditions in countries change over time. In short, the ROI vendor must have access to a productivity data base developed by professional economists.
3. Must measure true outcomes. Simply saying that users of the program had an enjoyable experience, or walked 1,000 steps, or are watching their diet, or taking yoga courses are hardly outcomes. Outcomes must have a specific impact on measurable physiological risk factors like blood pressure or glucose, or number of hours slept, or less anxiety, or less back pain, or less absenteeism and presenteeism, or less Covid hospital stays etc.
4. Must convert improved outcomes into financial terms. Saying that a program reduced blood pressures is still not useful to a financial decision maker who must decide on whether to allocate funds to a program. The reduction in blood pressure must be converted to less heart attacks, which must be connected to less medical costs and absenteeism, which then must be added to the other savings from the program. Then one must determine in which year these savings will take place, and then discount to the present value of money, and then consider that the Financial Director could have invested funds in alternative safer investments (this is considering the “opportunity cost of money”).
5. Must connect the dots of prevention programs. Prevention programs seldom impact just one condition. An exercise program can impact CHD, Diabetes, Anxiety, Stress and Muscular Skeletal conditions. Furthermore, the impact on one condition can be almost immediate (like stress) but takes months (if not years) to have an impact on CHD. Thus, the ROI Calculator must be able to capture the savings as they occur and convert savings in different times periods into today´s money before converting to an ROI.
6. Must measure the impact of a negative ROI on dependents. Some programs are offered to dependents. Yes, in some countries where a reduction in health care premiums is considered important, a program applied to dependents can result in some health plan premium savings but, generally speaking, the ROI is negative. Should the extension of a program to dependents be eliminated? Of course not! But the negative ROI from the extension of a program to dependents should be subtracted from the positive ROI of the employees to generate a net ROI.
7. Must be independent and unbiased. Numbers are sometimes cruel. If a vendor has priced its products too high as compared to the outcomes and financial results delivered, then we should call a spade a spade. Simply adding things like “increased happiness” or other “value added” benefits like improved attitude to the results of a program does not meet the approval criteria for financial decision makers. Program providers should be held responsible for their outcomes and how they are measured. HR and Benefits managers have a choice of just checking a box and provide a program at the lowest cost without any outcomes measurements other than vague and meaningless statistics of program results or bite the bullet and learn how to ask key outcomes questions. This brings me to the last “ingredient”.
8. Must offer training and support on how the ROI calculations were made. We have to avoid “black boxes” when calculating the ROI. Most HR personnel and Benefits Managers did not take financial theory classes in school. So, the provider of ROI calculations has the obligation to train HR personnel on the methodology, and support HR personnel in obtaining budget approval of programs.
9. Must adhere to Personal Data Base Protection and Privacy Laws of each country.Over the past few years there has been an increased focus on protecting the personal health data of users. An ROI calculator must be able to generate ROIs of prevention programs without gathering personal health data and must rely on average improvements in health factors.

For more information, please visit our web site at www.wellcastroi.com

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Nevertheless, nowadays it is difficult to obtain approval of prevention programs without some type of ROI calculation. Leaving aside philosophical differences, the good news is that the same methodology used in deciding to fix a car is used to decide to invest in a prevention program. If I leave philosophy aside for a minute, and think like an economist, it is quite possible to compare both. The human body is far more complex than a car and has many more moving parts.

Whereas a mechanic can fix a car, it takes many “specialized mechanics”, with many years of education to fix a human body. Furthermore, the parts of the human body are interrelated and sometimes not even understood. That explains why there are literally hundreds of types of prevention programs compared to taking your car to a single dealer to get it repaired. Each prevention program “tinkers” with one or more body parts, leaving other parts to survive on their own.

Read more: How to quantify productivity cost savings from wellbeing programs?

Take care of a prevention program is like looking after of machine

Let´s continue with the analogy. If an important car part malfunctions, the car stops. Its productivity goes to zero. However, with human beings, if an important component breaks down (say with back pain), other parts continue to function (the mind functions) but with less productivity. With a car, either it works or does not, whereas someone with anxiety or depression gives the appearance of productivity (after all, they are at their desk), but the mind does not work on all “cylinders”.

So, if we can admit that humans have productivity (few would doubt that), it become a question of how to measure the impact of physical and psychological conditions on productivity, and how a specific prevention program impacts the reduction of productivity. Also, if one admits that productivity exists, can I push my luck and claim that productivity varies by occupation and industry. So, if I had a data bases of productivity contributions by occupation and industry, I can be quite specific about the cost of conditions and how much they can be reduced by programs.

What should you do considerer in a prevention program?

Another consideration is that whereas some programs focus on a single condition (like vaccinations against Covid), other programs (like exercise) impact a multiple of conditions (CHD, Diabetes, Musculoskeletal).

So, one has to look at how the program (in this case, exercise) impacts the productivity costs of each of these three diseases. Obviously, there are other cost reductions associated with prevention programs (e.g., medical costs, turnover, disability, and accident costs) but I have just focused on productivity for now.

If you can calculate reduced costs, it is possible to calculate ROI. Our website contains the specific financial calculations. Obviously, there are other non-quantifiable benefits from having healthy bodies and minds, such as happiness and fulfillment, but luckily the ROI´s generated from just increased productivity are more than sufficient to obtain approval of your programs. The rest is gravy.

O post What do Investments in Machinery and Equipment and Prevention Programs have in Common? apareceu primeiro em Wellcast ROI™.

I have written many blogs and posts regarding how to calculate the ROI of prevention programs. But I would now like to step back and take a broader, or strategic view, of prevention programs.

Looking at the employee population, should there not be a variety of programs, some with long, medium, and short-term results, each with an ROI and level of risk in effectiveness? This is what we do in creating a balanced investment portfolio.

Read more: How to quantify other economic savings from wellbeing programs

Here’s an interesting example for you

Let´s take a look at the world before Covid. We were happy with our programs in preventing CHD, diabetes, smoking cessation, and high-risk maternity. Yes, we did have a sprinkling of EAP and stress reduction programs. Then came Covid, and all of a sudden, we focused almost exclusively on those programs dealing with psychological issues (some companies even had a combination and EAP, Digital Behavioral Platforms with little measurement of effectiveness, and a variety of stress reduction programs-it was the “Shoot, Ready, Aim approach”).

We did not even hear about physical diseases anymore, as they suddenly disappeared. Then came the Covid vaccinations and they became (rightly so) the highest priority. But all of a sudden, CHD and Diabetes started rearing their heads as if they had disappeared, on top of lingering Covid strains, and long forgotten polio, dengue, and meningitis.

In financial markets terms, this was a “trader” mentality-find a profit today not tomorrow. What we need is a balanced portfolio of preventive care programs, so that employers do well, no matter what happens. This means taking a longer term, strategic view of preventing disease and behavioral conditions.

Yes, it is impossible to create a balanced portfolio of prevention programs. Just contact us for additional guidance on how to do so. www.wellcastroi.com.

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Diseases among dependents don’t usually generate many productivity losses for the employer. However, this may be the case when an employee catches a disease from a dependent or must skip work to care for a dependent. 

In most countries, diseases among dependents can also have an impact on healthcare premiums. 

Read too: How to calculate the ROI of Vaccination Programs

I used to think that vaccination against Covid was a short-term program, but lately, Covid has been associated with Long Covid and neurological conditions. Both these conditions can have a long-term impact.

Another example, HPV has been associated with cancers that take years to develop. So, if an employer has a relatively low turnover, providing an HPV vaccine today can avert costs tomorrow.

Furthermore, HPV-associated cancers are much more prevalent among females rather than males. With that in mind, a vaccination program against HPV should be considered very seriously among industries dominated by females.

Vaccines against polio and meningitis have similar considerations. These diseases among adult populations have minimal direct impact, but the time employees have to take off (absenteeism) and distraction levels (presenteeism) are exceptional if a young dependent develops these diseases.

Also, if an employer has a considerable number of expats or employees who travel to less developed countries, a package of vaccinations, focused on Chikungunya, Dengue, Yellow Fever, Hepatitis etc. should be considered as standard preventive care measures. 

However, one has to consider where the costs are incurred: in the country where they traveled to or back home.

The Good News in Calculating the ROI of Vaccinations

Although there are many considerations in calculating the ROI of each type of vaccine, there is good news: It is much easier to calculate the effectiveness rate and the investment cost of vaccines.

Unlike other prevention programs, such as programs for high-risk employees, and behavioral issues, where there are dozens of programs with multiple effectiveness rates, one only has to calculate the impact of the vaccine in preventing cases that lead to ICU, versus hospitalization, versus mild cases with treatment at home.

Usually, these effectiveness rates are peer-reviewed and contained in studies, and the investment cost is also quite simple to calculate. It includes the number of dosages that have to be administered, the cost of each dose, and the cost of administering the vaccine.

Please visit our website for additional information on how to calculate the ROI of prevention programs www.wellcastroi.com

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Most other departments within employers develop strategic plans for their departments, whether it be Operations, Manufacturing, Sales, and for expansion plans, but is rare to see one for prevention programs implemented by HR, Benefits, or Occupational Medicine, leading to a kind of “Shoot, Ready, Aim” approach to preventing physical, behavioral, and occupational injuries, and conditions.

This leads to difficulties in obtaining approval of programs by administrative and financial personnel, who continually ask the following questions (which would be addressed by a strategic plan):

• What are the main issues faced by our employees, both short and long term?
• If there are many diseases or conditions, which ones impact our internal costs the most?
• If we consider our internal costs of disease, such as productivity and turnover costs, instead of just the medical costs or the impact on insurance premiums, does the priority change?
• What should be the balance between programs that resolve issues quickly (e.g., an EAP program that addresses short term issues) versus those that take longer to work (e.g., for high-risk employees)?
• Why do you have so many programs focused on the same disease or condition?
• Assuming that a single program impacts various diseases or conditions, how do you measure the impact on each?
• Granted that there are many alternative prevention programs for each condition, why did you choose the ones that you did?
• What is the ROI and Internal Rate of Return of each prevention program?
• Who are the target employees?
• What is the minimum participation and effectiveness rates to break even on the investment?
• How do you measure success?

Read more: How to Convert Wellbeing Programs into Investments

In the following paragraphs, I’ll explain how to provide a theoretical approach to Strategic Planning for the prevention of disease in three steps, called Ready, Aim, Shoot!

Step One: Ready – Identifying the Problems and how to solve them.

First of all, we need to identify the major disease states or conditions by analyses of actual or expected risk factors or prevalence rates. Then, we must quantify the costs associated with the incidence (internal or economic costs such as productivity losses, turnover, disability/claims, impact on health plan premiums, and accident costs). Following this, we must create a comprehensive list of potential programs focused on the major diseases or conditions.

Step Two: Aim – Selecting the Best Option with ROI

Now we need to compare the programs based on ROI (WELLCAST ROI simulations are run with various scenarios of price, participation, and effectiveness rates to determine respective ROIs). Subsequently, we’ll need to select the programs based on the results of the simulations. The original list is whittled down, and specific programs are selected for each disease state or condition. Note that WELLCAST ROI considers the fact that several programs affect various diseases and accounts for the cumulative effect.

Afterward, it’s necessary to obtain approval for programs based on ROI, and identify who will be conducting the programs, either In-house personnel or third-party vendors.

And, to conclude, we’ll have to prepare and communicate campaigns by Identifying target populations for each program, and, after that, prepare promotional materials and communicate the necessity of the program.

Step Three: Shoot – Program Implementation and Analysis

With all the above steps concluded, it’s time to implement the programs and measure their progress in reducing risk factors or disease/condition incidence.

With that in mind, we can now convert program progress and effectiveness (e.g., reduction of risk factors) into monetary terms (ROI). Hence, we’ll be able to periodically perform variance analyses by comparing actual reductions with the plan’s expectations, and then, convert variances into monetary terms.

Further details are contained on our website, www.wellcastroi.com

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Like vaccination programs, there are a variety of screening programs to choose from: blood pressure, cholesterol, weight & BMI, glucose, stress, Covid, mammograms, colon, etc. Some can be performed at health fairs or within employer premises, while others require medical diagnostic equipment.

What do they all have in common? In short, they are all intended to catch medical and behavioral issues early before they develop into something more serious. So, what variables should be considered in measuring their ROIs?

Variables to be considered to calculate the ROI of Screening Programs

The “Program Investment” would be the cost of the program, which includes the cost of the test, equipment, staff to administer the screening, and employee communications material.

The future savings or cost reductions used in the ROI calculation would be the averted costs of the physical or behavioral condition that would be generated if these conditions are caught early.

These cost reductions could occur quite quickly for conditions that develop over the short term, such as Covid or behavioral conditions, or they can develop more slowly, over the medium or longer term, such as Diabetes, Breast Cancer, or CHD.

Why is the term so important? Because, over time, we must consider the inflation rate of medical treatment costs and/or premiums, and the opportunity cost of money.

But medical costs or impact on the health care plan premiums are just one of the “big six” costs impacted by prevention programs that I keep mentioning in my blogs.

What are the other five? They include absenteeism, presenteeism, replacement costs (including training and relocation costs of new employees who replace employees who leave an employer due to a condition), accidents, and disability.

Each of these costs are impacted differently, depending on the condition. Also, the participation and effectiveness rates of the screening must be considered in calculating the ROIs of these programs. So, what is left? Just because a screening program identifies a condition, it is too early to declare victory.

Some action must be taken to “treat” the condition. This is where the real work begins on the part of the employee.  So, in calculating the ROI of the program, in addition to considering the effectiveness rate of the screening in identifying a condition, one must consider the probability of the employee with the condition taking some action to address the condition.

Let us make it easy for you

Again, I reiterate that the days of convincing decision-makers to approve prevention programs based on back-of-the-envelope calculations, or “think of the suicide or heart attack that we prevent” are over. Certainly, tools like the WELLCAST ROI Calculator will make your job a lot easier, if not more credible.

Based on my 25 years of experience in calculating the ROI of prevention programs, the ROIs of screening programs are exceptional. Even more so if action is taken to address the conditions that are uncovered.

For more information on calculating the ROI of prevention programs please check out our website: www.wellcastroi.com.

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